When a person loses the ability to hold in their stool (continence), it is mainly due to damage of the rectal nerves or muscles that control your bowel movements. In order to maintain continence, the anus, rectum and nervous system all have to be working together. If the muscles on the wall of the anus and rectum are at all compromised, a person’s ability to hold in stool will, in turn, be affected. Continence also relies on the body’s ability to notice the presence of stool in the rectum, as well as the body’s ability to relax and store stool while using the bathroom. If any of these dexterities become weak or none compliant, incontinence is what ensues.
Diagnoses of fecal incontinence are most often based off of a healthcare providers evaluation of a patient’s medical history, an in-office physical exam, and other related blood or imaging test results.
Patients are often asked to log their bowel movements as well. How frequent is your incontinence? Was it liquid or solid stool? Were you able to sense the need to go? How heavy of an impact does is it having on your day to day life? Do you need to wear a pad? In doing all of that, your physician will be able to better evaluate the severity of your condition, as well as implement the proper course of treatment.
A physical examination can also assist in confirming the severity as well as the cause(s) of a patient’s incontinence. This may include a visual exam of the anus, a physical finger exam of the anus, and or an anoscopy, or a look at the anal canal with a small scope.
Further diagnostic testing may also be required to confirm the exact cause of a patient’s incontinence. One of the most common examinations performed is anal ultrasound. During this test, the ultrasound machine takes multiple pictures which can uncover damaged or abnormal function of the anal muscles.
Treatment for fecal incontinence can vary. Sometimes, for less severe cases, a simple change in diet and nutrition is all that is needed. For patients suffering from more severe incontinence, treatment can include biofeedback, surgery, or the latest and most favorable procedure, electoral nerve stimulation or Axonics Therapy.